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. 2024 Oct 31:55:101544.
doi: 10.1016/j.ijcha.2024.101544. eCollection 2024 Dec.

Postoperative delirium in patients undergoing TAVI versus SAVR - A systematic review and meta-analysis

Dimitrios Stavridis  1 , Angelique Runkel  2 , Anna Starvridou  3 , Johannes Fischer  2 , Luca Fazzini  4   5 , Hristo Kirov  2 , Max Wacker  1 , Jens Wippermann  1 , Torsten Doenst  2 , Tulio Caldonazo  2   6
Affiliations

Postoperative delirium in patients undergoing TAVI versus SAVR - A systematic review and meta-analysis

Dimitrios Stavridis et al. Int J Cardiol Heart Vasc. .

Abstract

Background: Transcatheter Aortic Valve Implantation (TAVI) and Surgical Aortic Valve Replacement (SAVR) have different levels of invasiveness which can result in different levels of functional status after the procedure.

Methods: We performed a systematic review and meta-analysis to detect studies showing direct comparison between TAVI and SAVR regarding postoperative functional status. The primary endpoint was the incidence of postoperative delirium (POD) after TAVI or SAVR, assessed using the Confusion Assessment Method (CAM). Secondary endpoints included 30-day mortality, stroke, major bleeding, and hospital length of stay (LOS).

Results: We identified 1,161 manuscripts, of which 10 studies (12,015 patients) were analyzed. TAVI patients had a significantly lower incidence of POD (OR: 0.35, 95 % CI, 0.26-0.48, p < 0.01) compared to SAVR patients. No significant differences were found in secondary outcomes between the groups.

Conclusions: TAVI is associated with a lower incidence of postoperative delirium compared to SAVR without compromising length of stay or other major clinical outcomes. Further research is needed to understand the impact of postoperative delirium on short and long-term outcomes.

Keywords: Meta-analysis; Postoperative delirium; SAVR; TAVI.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Forest plot for post operative delirium. CI: confidence interval, OR: odds ratio, SAVR: surgical aortic valve replacement, TAVI: transcatheter aortic valve implantation.
Fig. 2
Fig. 2
Graphical abstract. SAVR: surgical aortic valve replacement, TAVI: transcatheter aortic valve implantation.
See this image and copyright information in PMC

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